Journal
AMERICAN JOURNAL OF PERINATOLOGY
Volume 38, Issue 2, Pages 182-190Publisher
THIEME MEDICAL PUBL INC
DOI: 10.1055/s-0039-1696640
Keywords
gestational weight gain; cesarean delivery; small for gestational age birth weight; hypertensive disorders of pregnancy; large for gestational age birth weight
Categories
Funding
- NCATS NIH HHS [UL1 TR000153, UL1 TR001108, UL1 TR001414, UL1 TR001863] Funding Source: Medline
- NICHD NIH HHS [U10 HD063046, U10 HD063020, U10 HD063072, U10 HD063047, U10 HD063036, U10 HD063053, U10 HD063048, U10 HD063041, U10 HD063037] Funding Source: Medline
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The study found that inadequate and excessive gestational weight gain are associated with different adverse maternal and neonatal outcomes, including hypertensive disorders, Cesarean delivery, large for gestational age or small for gestational age birth weight, and neonatal intensive care unit admission.
Objective To determine the association between total gestational weight gain and perinatal outcomes. Study Design Data from the Nulliparous Pregnancy Outcomes Study: Monitoring Mothers-To-Be (NuMoM2b) study were used. Total gestational weight gain was categorized as inadequate, adequate, or excessive based on the 2009 Institute of Medicine guidelines. Outcomes examined included hypertensive disorders of pregnancy, mode of delivery, shoulder dystocia, large for gestational age or small for-gestational age birth weight, and neonatal intensive care unit admission. Results Among 8,628 women, 1,666 (19.3%) had inadequate, 2,945 (34.1%) had adequate, and 4,017 (46.6%) had excessive gestational weight gain. Excessive gestational weight gain was associated with higher odds of hypertensive disorders (adjusted odds ratio [aOR]=2.05, 95% confidence interval [CI]: 1.78-2.36) Cesarean delivery (aOR=1.24, 95% CI: 1.09-1.41), and large for gestational age birth weight (aOR=1.49, 95% CI: 1.23-1.80), but lower odds of small for gestational age birth weight (aOR=0.59, 95% CI: 0.50-0.71). Conversely, inadequate gestational weight gain was associated with lower odds of hypertensive disorders (aOR=0.75, 95% CI: 0.62-0.92), Cesarean delivery (aOR=0.77, 95% CI: 0.65-0.92), and a large for gestational age birth weight (aOR=0.72, 95% CI: 0.55-0.94), but higher odds of having a small for gestational age birth weight (aOR=1.64, 95% CI: 1.37-1.96). Conclusion Both excessive and inadequate gestational weight gain are associated with adverse maternal and neonatal outcomes.
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